[Clinical aspects of staphylococcal endocarditis].
Patients with staphylococcus endocarditis hospitalized at the Cantonal Hospital Lucerne from 1971 to 1988 are reviewed. A total of 50 patients fulfilled the diagnostic criteria (in 60% of the cases the diagnosis was definite, in 26% probable, and in 14% possible). These 50 patients with staphylococcus infection account for 29% of all patients with infective endocarditis seen during this time interval. Staphylococcus endocarditis affected the mitral valve in 48%, the aortic valve in 36% and--unexpectedly often--the tricuspid valve in 30%. In 54% previously normal valves were infected. Diminished host defence (predominantly intravenous drug addiction and diabetes) was a predisposing feature in 52% of the patients. The average duration of symptoms before diagnosis was 11 days, and in patients with right heart endocarditis it was 21 days. In 20% the condition was not diagnosed before autopsy. The clinical picture was relatively nonspecific: 50% of patients had no diagnostic heart murmur and 10% had no fever. The dominant--often misleading--symptoms were due to embolic complications. Two thirds of the cases with right heart endocarditis had pulmonary emboli. In 38% of the patients endocarditis resulted in heart failure. Overall mortality was 51% and correlated with age and the presence of heart failure, uncontrolled infection or cerebral embolism. In contrast to the high mortality in patients with mitral valve infection (61%), only one of the 11 patients with isolated right heart endocarditis died.
Garzoni
D
D
Medizinische Klinik, Kantonsspital Luzern.
Nager
F
F
D004697:Endocarditis, Bacterial / Q000150:complications / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology; D006349:Heart Valve Diseases / Q000209:etiology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D011655:Pulmonary Embolism / Q000209:etiology; D013203:Staphylococcal Infections
Zur Klinik der Staphylokokkenendokarditis.